WAG 18-05-06: Authorizing Extended Medical for TANF, Family Assist

Funds for extended medical benefits are a 50/50 match of state and federal funds. This applies to cases where TANF or Family Assist was received for 3 of the last 6 months before income increased above the TANF or Family Assist level, and the person who has increased earned income or spousal support is in the benefit unit.

The following examples show how the medical extension works:

Example 1: Ms. Rose has received TANF since January, and starts working in early June. Due to the earned income, she will no longer qualify for TANF effective July. The potential 12-month extension starts with July and ends the following June. This period applies even if the income was not reported in June.

Example 2: Mr. Laurel received FamilyCare since February and his income has been below the Family Assist standard since May. He starts a new job on September 1st and his earnings exceed the Family Assist Standard beginning in October. He does not report his increased earnings until January. Since October would have been the first month that his income exceeded the Family Assist standard had it been reported timely, his potential 12 month extension starts with October and ends the following September.

Example 3: Mrs. Ivy, who is in a TANF unit with her grandchildren for at least 3 of the last 6 months, goes to work. She earns enough to make herself ineligible for TANF cash, but her grandchildren stay eligible. The grandmother qualifies for extended medical.

Example 4: Mr. Flores received FamilyCare since May and his income fell below the Family Assist standard for the first time in August. He starts a new job on September 1st and his earnings exceed the Family Assist and FamilyCare standard effective October. Mr. Flores does not qualify for extended medical because his income has not been at or below the Family Assist level for at least 3 of the last 6 months. His medical benefits are canceled and he is referred to the Marketplace.

Legacy System Type Action Reasons (TAR)

For TANF, the TAR reflected the reason the case was canceled:

TARs 14, 57, and 58 were related to earned income; may receive medical extension up to 12 months.

TAR 21 was related to receipt of spousal support; may receive medical extension up to 4 months.